Repetitive Strain Injury

Why does my elbow still hurt?

I developed a repetitive strain injury in my elbow this past year. At first, I thought it was an injury from lifting; I decided to rest my arm and let it be. However, the pain got worse. I couldn’t grip things with my left hand; I couldn’t sleep without propping my arm on a pillow; I couldn’t put a jacket on without wincing. After 4 months of this pain, I finally decided to see my doctor. It took her less than 5 minutes to diagnosis the problem as tennis elbow, a type of repetitive strain injury. Since I don’t play tennis, I may never know what repetitive movement caused this injury (dishwashing, maybe?), but now I know how to recognize the signs and to reduce my risk.
Keep reading to find out more about repetitive strain injuries and how to reduce your risk of developing one from computer use.

What is Repetitive Strain Injury

Tennis elbow is a common name for a repetitive strain injury (RSI) known as lateral epicondylitis.  This is caused by overuse of the muscles and tendons located where bone and tendons join in the elbow. You may have heard of other RSIs, including golfer’s shoulder, carpal tunnel syndrome (median nerve compression), and stylus finger. These are all repetitive strain injuries that affect different parts of the upper extremities. As Johansson describes in his informative book What You Can Do About Carpal Tunnel Syndrome and Other Repetitive Strain Injuries (Contemporary Diseases and Disorders), RSIs are also known as

• CTD - cumulative trauma disorder
  
• RMD - repetitive motion disorder
  
• MSD - musculoskeletal disorder
  
• OOS - occupational overuse syndrome
• WRULD - work-related upper limb disorder

The Cleveland Clinic gives a good overview of what RSIs are and how they develop. Briefly, they all stem from microinjuries in joints and ligaments that occur repeatedly during daily activities. The body doesn’t have time to heal these micro wounds because the injury keeps occurring (think typing). We are all at risk of RSIs because of the repetitive movements of jobs, sports, and other hobbies, including music!

The association between repetitive movements and work has been extensively studied and reviewed. RSIs are very costly to employers in the form of lost work hours and costly to employees due to pain, prolonged injury, and lost income. As described in a report from the Centers for Disease Control and Prevention, the best way to combat the problem of work-related RSIs is to implement work practices and environments that reduce the risk of developing these injuries. These practices include

• Engineering controls (changing the layout of a workstation)
  
• Administration controls (changing job rules or procedures)
• Personal protective equipment (the jury is still out on whether braces are effective measures of prevention)

RSIs at the desk

Extended computer use is a well-known risk factor for developing an RSI. A recent literature review states that more than 50% of computer users experience some form of MSD, with the most common areas affected being the back, neck and shoulder. Unfortunately, if you’re a writer, editor, or administrator (and many others), your job probably involves extended computer use and sitting for long periods. So what can we do?

How to reduce the risk of RSIs in editing and writing

In a 2005 in-depth review on MSDs and computer work, Wahlström cites studies on the association between computer work-related injuries and muscular load, postures and movements, and force.  To reduce work-related—including computer work—risk of RSIs, the field of ergonomics emerged. Ergonomics entails modifying a work environment to reduce the repetitive motions or postures that increase the risk of RSIs. As I stated above, this is a type of engineering control: modifications of the types and setup of chairs, desks, keyboards, and monitors can help reduce the risk. Dygma gives a great summary of how to ergonomically set up your work station in their How to Prevent RSI with an Ergonomic Setup article.

Here is another good article with 10 suggestions for preventing RSIs.

Aside from an ergonomically setup workstation (discussed above), you should take breaks from your desk (at least every hour), use good posture and support your back and arms, and reduce the amount of keyboard use.

Tools to reduce mouse and keyboard use

So how does an editor or writer reduce keyboard and mouse use. In my experience, my job is typing and mouse work! Each keystroke requires pressure from a finger. And if you add up all the keystrokes over 8 hours of computer work, that’s a lot of pressure. For an interesting and high-level discussion on the pressure of typing, check out this post on keyboard switch forces.

To reduce the number of keystrokes and mouse movements throughout the day, you can try the following:

• Macros
• Shortcut keys
  
• Text expander
  

Macros

Macros are little computer programs that automate repetitive tasks. Paul Beverley has an outstanding list of macros that are free to download and use. He also has YouTube videos about how to use macros in writing and editing.  

Do you need to make a list of all the hyperlinks in a document? There’s a macro.

Do you need to find the next highlighted item? There’s a macro.

Do you need to remove all highlights and/or text colors? Yes! There’s a macro.

Check out my previous post on Macros to find out how I use these wrist-saving tools!

Shortcut keys

Another way to reduce the number of keystrokes (and mouse use) is to use shortcut keys. Google shortcut keys to find lists of the shortcuts that are already within your writing software. Here’s just a few of the ones I use regularly.

• Crtl+V – paste
• Crtl+S – save
• Crtl+home (end) – go to the start (or end) of the document

And so on!

You can also set your own shortcut keys. And yes, you can assign shortcut keys to macros! (I highly recommend this for macros you use while editing: “InstantJumpUp”, “HighlightFindDown”, “GoogleFetch”, etc.)

To customize shortcut keys, go to your ribbon and right click. Click on “Customize the ribbon…”. Click on “Keyboard shortcuts: Customize” from there you can assign any combination of keys to many different commands. Have fun!

Text Expander

Text expanders are tools that allow you to automate repetitive typing. They use snippets, which are shortcut phrases that insert long phrases, sentences, and blocks of text. Check out this post for a comprehensive guide to text expanders.

When I’m editing, I often leave the comment “Please ensure that my change doesn’t alter your intended meaning.” That’s a 10-word sentence that I type in almost every comment bubble. If I used the snippet, pec, then the text expander would automatically insert the full sentence.

This saves time and pressure on my fingers and wrists.

Awareness is key!

RSI is a serious injury that we may all be at risk of developing. With a few changes in habits and useful tools, we can reduce our risk of this costly disease. Do you have tricks for reducing the risk of RSIs? I’d love to hear from you.